Administering Medication in Schools
Whenever possible, a student’s medical needs should
be met outside the school. However, if a student is required
to take medication during the school day, the administration
of such medication shall comply with the following guidelines.
A. General Guidelines
The following shall apply to the administration of both prescription
and non-prescription medication in school:
1. The school nurse shall be notified of all prescription
and non-prescription medications to be used during school
and/or school activities.
2. No medication shall be administered to any student unless
the principal and the school nurse determine that the school
has the capacity to administer the drug safely and address
any possible side effects should they occur.
3. Records shall be kept of all prescription and non-prescription
medications administered in school.
4. No student shall have prescription or non-prescription
medication on his/her person during the school day, with the
exception of inhalers for respiratory concerns and epinephrine
auto-injectors in case of severe allergy, provided the school
nurse has prior written permission from the student’s
parent/legal guardian and physician. Unique individual circumstances
will be addressed in consultation with the parent/guardian
and the student’s physician.
5. Students shall not share prescription or non-prescription
medication with other students.
6. The school nurse and school principal, in conjunction with
the parent/guardian, may make arrangements to have the medication
administered to the student in situations during which the
school nurse cannot be present.
7. If an adult other than the school nurse is required to
administer the medication, training this individual shall
be the responsibility of the parent/guardian, and the parent/guardian
shall certify that appropriate training has occurred.
B. Prescription Medication
The following shall apply to the administration of prescription
medication in school:
1. A student who is required to take, during the school day,
medication prescribed by a licensed physician, advanced registered
nurse practitioner, licensed physician’s assistant,
or dentist, shall have the school nurse either administer
the medication or assist the student in taking the medication.
However, the school nurse may delegate the administration
of medication to others, if appropriate, pursuant to RSA 326-B
Nurse Practice Act and Nur 404.
2. A student with chronic illnesses (e.g., asthma, seizure
disorders, cystic fibrosis, diabetes, etc.), who is capable
of administering medication to himself/herself, may be allowed
to do so with the permission of the parent/guardian and physician,
and under the supervision of the school nurse.
3. The school nurse shall ensure that a written statement
from the licensed prescriber is in the student's health record
containing the following:
a. The student's name;
b. The name and signature of the licensed prescriber and contact
c. The name, route and dosage of medication;
d. The frequency and time of medication administration or
e. The date of the order; and
f. The student’s diagnosis, if not a violation of confidentiality;
The order may be faxed to the school, but an original copy
of the order must be produced within 24 hours of receipt of
the faxed copy. Note that a pharmacy label does not constitute
a written order and cannot be used in lieu of a written order
from a licensed prescriber.
4. Upon receiving a request from a student’s parent/guardian,
physician, or other medical practitioner regarding the student's
need for medication during school hours, the school nurse
may contact the parent/guardian to discuss whether the student
should remain at home, or whether the medication should be
taken before, during, and/or after school. The nurse may also
inquire about any other medical conditions requiring medications
and any side effects, contraindications, and adverse reactions
to be observed.
5. The school nurse shall ensure that there is written authorization
by the parent/guardian for the administration of the medication
in school, which contains:
a. The parent/guardian's printed name and signature;
b. A list of all medications the student is currently taking,
if not a violation of confidentiality or contrary to the request
of the parent/guardian and/or student;
c. The parent/guardian's home and emergency telephone number(s);
d. The names of persons to be notified in case of a medication
emergency, in addition to the parent/guardian and licensed
6. The parent/guardian is responsible for having the medication
delivered by a responsible adult directly to the office of
the school nurse. The medication must be brought to school
in a container appropriately labeled by the pharmacy or physician
with the student's name, physician's name, date of original
prescription, expiration date, name and strength of medication,
and indications and directions for administration.
7. The parent/guardian is responsible for ensuring the student’s
medication is up-to-date.
8. Non-emergency medication shall be kept in the school nurse's
office in a locked cabinet or refrigerator unless otherwise
indicated. No more than a 30-day supply shall be kept and
maintained by the school. Emergency medication may be secured
in other locations readily accessible only to those with authorization.
9. Unused medication shall be returned to the parent/guardian.
10. The school nurse may administer a physician-ordered off-label
medication (an FDA-approved medication prescribed for an indication
for which it has not been approved) to a student if all the
above conditions apply and:
a. The school has a physician-signed medical order for the
administration of the off-label medication that specifies
the dose, route, and conditions under which the off-label
medication is to be given;
b. The student’s physician has provided a specific procedure
to guide the safe administration of the off-label medication
to the child. This will include indications, directions for
preparation of the medication for administration, supplies
necessary for administration, conditions necessary for the
storage of the medication, and information about possible
side effects; and
c. The student’s parent/guardian has given signed permission
to the school nurse to have the medication administered to
C. Non-Prescription Medication
The following shall apply to the administration of non-prescription
medication in school:
27. Written permission from the parent/guardian must be provided
if a non-prescription/over-the-counter medication is to be
used during school hours or activities.
28. Non-prescription medication must be brought to school
in a properly labeled container, in original packaging, and
must be left in the nurse's office .
NH Code of Administrative Rules, Section Ed 311.02, Medication
During the School Day.
ADOPTED: 19 November 1992
REVISED: 8 December 1994; 18 November 2010